| Q:
What is a total knee replacement?
A:
During this operation, the diseased and arthritic parts
of the knee joint are removed and replaced with an artificial
joint made out of metal and plastic.
Q:
Who benefits from a total knee replacement?
A:
A total knee replacement is a quality of life improving
operation. Patients with end stage arthritis of the
knee where all other therapeutic measures such as painkillers,
anti-inflammatories and activity modification have failed
to relieve pain, will be offered a knee replacement.
Q:
What is the recovery time after a total knee replacement?
A:
Most patients stay in hospital for three to five days
and leave the hospital with two walking sticks. Adequate
pain control in the days and weeks after the operation
is essential. A knee replacement is more painful than
a hip replacement and the recovery period is also longer.
Most patients regain a good level of function with little
pain after three to six months but in some cases it
can take up to eighteen months to have the full benefit.
Q:
How successful is a total knee replacement?
A:Eighty percent of patients are very satisfied for up
to 15 years after the initial operation.
Q:
How long will a total knee replacement last?
A:
This depends on the age and activity level of the patient
but a modern prosthesis should last about 15 years.
Q:
What are the complications following a total knee replacement?
A:
Medical complications: Heart attack, stroke, blood clot in leg, pulmonary embolism, kidney and lung problems encountered during of after the operation.
Surgical
complications:
-
Wound healing problems (2-5%): Normally, the wound heals in two to three weeks. A small number of patients will experience a slow healing wound with swelling and excessive fluid production. This can be the first sign of an infection but in most instances, regular cleaning and change of dressing by a qualified practitioner, will result in healing. Patients who suffer from diabetes are more prone to wound healing problems than others.
-
Infection (1%): A deep infection around the prosthesis is a serious complication and can happen at any time after surgery. It is more common months and years after the surgery than immediately afterwards. Bacteria from a urinary tract infection can reach the knee joint via the bloodstream and cause an infection there. Most common symptom is new onset of pain after months and years of pain-free function. If a deep infection is confirmed with blood tests and fluid aspiration from the joint, a two- stage exchange arthroplasty is usually necessary.
-
Stiffness and pain: Most patients regain good and pain-free range of motion three to six months after surgery but a small number experience prolonged stiffness and pain for up to 18 months. Physiotherapy and and pain-killers can help but sometimes further surgery is necessary. Good pain control and aggressive rehabilitation after the operation are very important. The Caledonian Technique developed in Denmark and at the Golden Jubilee Hospital in Glasgow has been very successful here.
-
Aseptic loosening: No knee replacement will last forever and depending on the age and activity level of the patient, a revision knee replacement might be necessary later on.
-
Nerve injury: Major nerves are rarely injured during the surgery. Most recover within two years and permanent damage such as a foot drop, is rare.
|
